粤北地区慢性化脓性中耳炎与中耳胆脂瘤致病菌及药敏分析

Pathogenic bacteria and drug sensitivity analysis of chronic suppurative otitis media and cholesteatoma in Yuebei area

目的研究粤北地区慢性化脓性中耳炎和中耳胆脂瘤患者的致病菌,分析其药物敏感性,指导临床合理用药。方法收集2015年1月2019年12月就诊于粤北人民医院耳鼻咽喉科门诊560例慢性化脓性中耳炎患者和住院98例中耳胆脂瘤患者,取患者中耳分泌物,进行病原菌分离鉴定及药物敏感性分析,两组间相互比较,并进行统计学分析。结果病原菌检出率78.0%,慢性化脓性中耳炎组检出率80.7%,革兰氏阳性菌检出率高(59.8%),最常见的为金黄色葡萄球菌;中耳胆脂瘤组检出率为62.2%,革兰氏阴性菌检出率高(52.2%),最常见的为铜绿假单胞菌,差异均有统计学意义。两组真菌检出率无明显差别。不同致病菌对抗菌药物的敏感性不同。结论金黄色葡萄球菌、铜绿假单胞菌是粤北地区中耳炎常见致病菌,不同疾病常见致病菌不同。常见致病菌对青霉素、红霉素等临床常用药物耐药性高,临床医师应根据患者的病情进行经验性用药,条件允许时应进行细菌培养,选择敏感的抗生素治疗。

OBJECTIVE To study the pathogenic bacteria of middle ear cholesteatoma and chronic suppurative otitis media in Yuebei area and analyze their drug sensitivity in order to guide clinical drug use.METHODS From January 2015 to December 2019,560 patients with chronic suppurative otitis media and 98 patients with cholesteatoma of middle ear were collected and their ear canal secretions were collected for routine bacterial isolation,identification and drug sensitivity analysis.The two groups were compared and statistically analyzed.RESULTS Out of 658 cases of ear secretion samples,pathogenic bacteria were cultured in 513 cases,the detection rate was78.0%,among which 489 cases were bacteria,43 cases were fungi.And the positive rate was 80.7% in patients with chronic otitis media,the main bacteria were G+ bacteria(59.8%).The main pathogens were staphylococcus aureus.The positive rate of middle ear cholesteatoma was 62.2%,and the main bacteria were G-bacteria(52.2%).The main pathogens were seudomonas aeruginosa.Sensitive drugs were different from strains.CONCLUSION Staphylococcus aureus and Pseudomonas aeruginosa were the main pathogenic bacteria.Common pathogenic bacteria were resistant to penicillin and erythromycin,which were commonly used in clinic.Therefore,clinicians should use empirical drugs according to the patient’s condition,bacterial culture should be carried out to select sensitive antibiotics.